Anthem BCBS PPO VA? Anyone w/exp?

alegna242 · March 31, 2008

Hi-

I have been one of the many Americans without medical insurance (and I work in the medical field!) for over 5 years. Anywho- I just recently found out that we are getting Medical Insurance through Anthem BCBS PPO Virginia (I live in Texas). I am still in the process of filling out initial paperwork ect. I don't officially have the insurance quite yet but will in the next few weeks. I have not gotten my official disclosures and medical coverage explanation packet yet but I am hoping that one of you out there have had a good experience through them and gotten accepted?!?! The one thing besides total non coverage for the band that I am worried about is that they are going to need 5 years of medical history. I have not had insurance and therefore I have not had a continuous medical history at all. Am I SOL? If anyone has any suggestions on getting started, Dr.s, Lawyers, anything please let me know! I live the The Woodlands Texas area (30 miles N. of Houston) Thank you!

taylormomto6 · April 1, 2008

I'm sorry I don't have the answer for you, but I just want to say you are not alone. I have also been without insurance therefore been without medical care and am just now getting Blue Shield Access HMO through my husbands employer. It is supposed to take effect today, but I have not yet received my benefits card.

I can tell you that on the benefits paperwork they gave DH, it does state weight loss surgery is covered if medically necc.

I believe the 5 years is to show you didn't just suddenly gain weight, that it has been an ongoing problem. I could get records from ob/gyns that cover 20 years, just not the last 5, so I guess I'll just have to see how anal they want to be and keep appealing if they don't approve it.

Good Luck and I'll be watching your responses.

Cindy T

alegna242 · April 2, 2008

oh thanks. I am calling the HR Dept today just to ask some simple questions to make sure my paperwork is ok and they can't even give me a straight answer! UGH. I guess I will have to just wait for them to decide when my enrollment date is ect. and THEN I'll get me break down of my benefits. I have a feeling this isn't going to go smoothy. I appreciate your response and I will be watching you too. :wink_smile:

dustout · April 7, 2008

Anthem covers Lapband. Check this link for all the details to see if you qualify under their terms.

Note that your employer may have opted to EXCLUDE this, but it is there by default. Check with Anthem on your exact policy to verify. You can quite this policy and make sure you dont have an exlusion.

SURG.00024 Surgery for Clinically Severe Obesity

They covered me 100%. I was 41 BMI, no co-morbidities.

There is another thread I started on Anthem here: http://www.lapbandtalk.com/f8/approved-anthem-blue-cross-blue-shield-42639/

alegna242 · April 8, 2008

thank you I will have to look into that. We don't have it at work yet but will. I've recently found out that its Anthem BCBS VA PPO keycare 1000. How does anyone keep up with all of it? My BMI is like 39 but I have back problems from childhood (one leg is longer than the other casing curvature) Ect. i thank all of you for your replys!